Maine Health Insurance Exchange Guide
Health Insurance • May 23, 2013 at 5:10 PM • Written by: PeopleKeep Team
This guide provides an overview of the Maine Health Insurance Exchange including the history of the exchange, how the exchange will operate, and exchange information for Maine residents and small businesses.
Maine Health Insurance Exchange Introduction
Beginning in 2014, as part of the Affordable Care Act (ACA), health insurance coverage for individuals and small businesses will become available through new state health insurance exchanges (also called health insurance marketplaces).
Most importantly, the key tax credits (e.g. the small business health care tax credits) and tax subsidies (e.g. individual health insurance tax subsidies) will only be available for coverage purchased through a state health insurance exchanges.
All states have three options for setting up a state health insurance exchange:
- Build a state-based exchange
- Enter into a state-federal partnership exchange
- Default to a federally-facilitated exchange
Maine originally defaulted to a federally-facilitated health insurance exchange. CoverME, Maine's state-run exchange, opened on November 1, 2021.
Maine Health Insurance Exchange - History
In November 2012, Maine Governor Paul LePage announced to federal officials that Maine would default to a federally-facilitated health insurance exchange. This came after legislation to establish a state-based health insurance exchange failed in 2011 and 2012. However, Maine maintained control of all plan management functions including contracting with carriers, reviewing insurance plan rates and plan compliance with ACA.
In 2021, the new state-based exchange, CoverME, opened.Maine Health Insurance Exchange - What is It?
CoverME is Maine's state-based health insurance marketplace. Starting in November 2021, Maine residents will be able to access information about all the plans available through the exchange. The SHOP exchange will also be available to small businesses with 50 or fewer employees.
According to an estimate by HealthCare.gov in 2013, 144,959, or 13% of Maine’s non-elderly residents, are uninsured.
Maine Health Insurance Exchange - What Plans will be Available?
All plans offered through the Maine Health Insurance Exchange will meet the ACA definition of a qualified health plan (QHP). The plans will be offered by level of coverage for essential health benefits (EHB), to allow consumers to compare plans on an "apples to apples" basis. The four "metal" levels are: Bronze (plan pays 60%), Silver (plan pays 70%), Gold (plan pays 80%) and Platinum (plan pays 90%).
